Equine Ch 15 Misc Flashcards

1
Q

What is the most common inflammatory nodular skin disease of the horse?

A

Eosinophilic granuloma

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2
Q

Where do lesions most commonly occur in eosinophilic granuloma?

A

Saddle region

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3
Q

What is a classic histopathologic feature of the eosinophilic granuloma?

A

Collagen flame figures

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4
Q

T/F Eosinophilic granulomas are typically non painful and nonpruritic.

A

True

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5
Q

What are the histopathologic findings of eosinophilic granuloma?

A

Multifocal areas of collagen flame figures. Small foci of eosinophilic folliculitis and furunculosis.
Lymphoid nodules may be prominent. Older lesions exhibit marked dystrophic mineralization and may be misdiagnosed as calcinosis circumscripta or mast cell tumors

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6
Q

What are the histopathologic findings of eosinophilic granuloma?

A

Multifocal areas of collagen flame figures. Small foci of eosinophilic folliculitis and furunculosis.
Lymphoid nodules may be prominent. Older lesions exhibit marked dystrophic mineralization and may be misdiagnosed as calcinosis circumscripta or mast cell tumors

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7
Q

What are some treatment options for eosinophilic granuloma?

A

Benign neglect - may resolve on their own
Surgical excision of solitary lesions
Sublesional injections of steroids q2 weeks
Systemic steroids for multiple lesions
Treatment of concurrent insect-bite hypersensitivity, atopy or food allergy

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8
Q

Which condition is characterized by multiple asymptomatic papules on only one side of the body?

A

Unilateral papular dermatosis

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9
Q

How is unilateral papular dermatosis treated?

A

Usually benign neglect. Undergoes spontaneous resolution and papules are typically nonpainful/nonpruritic.
Steroids cause rapid resolution.

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10
Q

What condition is characterized by three or fewer nodules, 1-10cm in diameter, typically present in the girth area behind the elbow?

A

Axillary nodular necrosis, aka focal nodular eosinophilic granuloma and arteritis

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11
Q

Describe the clinical signs seen in sterile eosinophilic folliculitis and furunculosis

A

Multiple tufted papules that become crusted and alopecic are symmetric and may be present anywhere on the body, although neck, shoulder, brisket and dorsolateral thorax most common.
Pruritus usually moderate to marked, occasionally mild.

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12
Q

What histopathologic findings would you expect to see with eosinophilic folliculitis and furunculosis?

A

Infiltrative-to-necrotizing eosinophilic mural folliculitis and furunculosis and occasionally, focal collagen flame figures. Focal areas of eosinophilic mural folliculitis, luminal folliculitis and furunculosis may be seen in biopsy specimens from horses with insect-bite hypersensitivity, atopic dermatitis, and food allergy in the corresponding clinical lesions (tufted papules)

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13
Q

What is the treatment for eosinophilic folliculitis and furunculosis?

A

Systemic steroids. Relapses common. Long term management best achieved by appropriate control of allergy.

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14
Q

How is multi systemic eosinophilic epitheliotropic disease characterized?

A

Exfoliative dermatitis, ulcerative stomatitis, wasting and infiltration of epithelial tissues by eosinophils, lymphocytes and macrophages.

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15
Q

Which breed has been reported in 70% of cases of multi systemic eosinophilic epitheliotropic disease

A

Standardbreds.

Thoroughbreds account for about 20% of all reported cases.

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16
Q

What systemic signs can be seen with multi systemic eosinophilic epitheliotropic disease?

A

Progressive weight loss, variable appetite (poor, normal, ravenous), pitting edema of ventral chest, abdomen, and distal limbs. Fever or recalcitrant diarrhea in up to 50% of cases.

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17
Q

What are some differential diagnosis for multi systemic eosinophilic epitheliotropic disease?

A

PF, SLE, sarcoidosis, BP, PV, vasculitis, EM, epitheliotropic lymphoma, cutaneous adverse drug reaction, and various toxicosis (vetch, stachybotryotoxicosis)

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18
Q

Describe the histopathologic findings in multi systemic eosinophilic epitheliotropic disease.

A

Intermingling of inflammatory reaction patterns: superficial and deep perivascular, lichenoid interface, interstitial, diffuse, and granulomatous. Eosinophils, lymphocytes and plasma cells are the dominant inflammatory cells.
Epidermal hyperplasia is marked and irregular. Hyperkeratosis is prominent and mixed (orthokeratotic and parakeratotic). Epitheliotropic infiltration of eosinophils and lymphocytes is typical, and apoptotic keratinocytes may be prominent. Eosinophilic folliculitis and furunculosis may be seen. Neutrophilic microabcesses and suppurative folliculitis and furunculosis.

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19
Q

What is the prognosis for multi systemic eosinophilic epitheliotropic disease?

A

Varies. Most horses suffer a progressive dermatitis and wasting over the course of several months (1-10) and are eventually euthanized or die.
May respond to steroids early in the course of disease, however horses usually do not respond.

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20
Q

Which breed of horse is predisposed to linear alopecia?

A

Quarter horses

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21
Q

T/F The lesions in linear alopecia are neither painful or pruritic.

A

True

22
Q

What are the differential diagnosis for linear alopecia?

A

Infectious folliculitis (dermatophytosis, dermatophytosis, demodicosis, staphylococcus), alopecia areata, and follicular dysplasia. Trauma (scratch, whipmark, dripping caustic material) or epidermal hamartoma (linear keratosis)

23
Q

What are the histopathologic findings for linear alopecia?

A

Early infiltrative lymphocytic mural folliculitis with variable outer root sheath edema, to a later lymphohistiocytic mural folliculitis.
Epithelioid cells and multinucleate histiocytic giant cells are prominent in chronic lesions and apoptotic keratinocytes and eosinophils may be found in the wall of the hair follicle.
Can see complete follicle destruction.

24
Q

How is linear alopecia treated?

A

Benign neglect. Steroids can slow progression, but lesions recur.

25
Q

T/F In horses, the majority of cases of sterile nodular panniculitis are of idiopathic origin.

A

True

26
Q

Which form of equine panniculitis has been reported in suckling or recently weaned foals?

A

Steatitis, yellow fat disease.

Rarely reported in mature horses and ponies, especially in spring and early summer.

27
Q

T/F Foals with steatitis do not typically develop signs of systemic illness.

A

False. They often have a fever, inappetence, depression, weight loss, and increased cardiorespiratory rates.
Some animals have skeletal muscle degeneration, resulting in lameness or stiff gaits.

28
Q

What are the differentials for sterile nodular panniculitis?

A

Granulomatous disease (infectious or sterile), neoplasia (esp lymphoma), and cysts

29
Q

Which stain can be used to help diagnose nodular panniculitis on FNA? What would it show?

A

Sudan stain - would reveal extracellular and intracellular lipid droplets

30
Q

Describe the histopathologic findings of panniculitis.

A

May be necrotizing, suppurative, pyogranulomatous, granulomatous or fibrosing.
Multinucleate histiocytic giant cells common.
Multiple lymphoid nodules common.

Steatitis in foals shows varying degrees of noninflammatory fat necrosis and secondary granulomatous panniculitis.
Ceroid is present in lipocytes, macrophages, giant cells, and interlobular CT septae.

31
Q

Which two stains can be used to identify ceroid and what would it look like?

A

Light brown-to-yellow homogenous material in H&E stains and is deep crimson color in acid-fast stains.

32
Q

What is the treatment for steatitis in foals?

A

No successful therapy has been described. Rare reports of spontaneous recovery.

33
Q

What is sarcoidosis?

A

Rare disorder characterized by exfoliative dermatitis, severe wasting and sarcoidal granulomatous inflammation of multiple organ systems.

34
Q

What is the causative agent of sarcoidosis?

A

One has yet to be identified.

35
Q

What are the histopathologic findings of sarcoidosis?

A

Nodular to diffuse sarcoidal granulomatous dermatitis that may affect all portions of the dermis
Multinucleate giant cells numerous

36
Q

What is the prognosis for sarcoidosis?

A

Varies with the chronicity and severity fo the disease. A few horses resolve spontaneously. Many horses suffer a progressive dermatitis and wasting over the course of weeks to months and are eventually euthanized.
Steroids may help if given early.

37
Q

What are the histopathologic findings for idiopathic sterile pyogranuloma?

A

Nodular to diffuse granulomatous or pyogranulomatous dermatitis at the level of the deep dermis. Panniculus is occasionally involved.
Multinucleated histiocytic giant cells numerous.

38
Q

How much fluid can a horse lose per day via sweat in strenuous exercise?

A

Up to 45L!

39
Q

What are the major electrolytes lost in sweat?

A

Cl, K, Na

40
Q

Which breeds are predisposed to anhidrosis?

A

Thoroughbred and warmblood

41
Q

Equine anhidrosis is believed to result from a conditioned insensitivity of sweat glands to ___________.

A

Epinephrine

42
Q

The level of ____________ expression in epithrichial sweat gland cells is substantially decreased in long-standing anhidrosis.

A

The level of aquaporin-5 expression in epithrichial sweat gland cells is substantially decreased in long-standing anhidrosis.

This suggests water channel impairment as a possible factor in the development of the disorder.

43
Q

What is the hypothesis of the development of anhidrosis?

A

Gradual failure of the glandular secretory cell processes, initiated by desensitization and subsequent down regulation of the cell receptors due to continued epinephrine-driven hyperactivity stimulated by climatic stress.
The process results in transcriptional down regulation of proteins integral to the secretory activation cascades in glandular cells and culminates in gradual, probably irreversible, glandular dedifferentiation and degeneration.

44
Q

Where is equine anhidrosis most prevalent?

A

Up to 20% incidence in hot, humid climates

45
Q

T/F Horses that have been imported into hot/humid climates from cool/dry climates are more likely to develop anhidrosis than native horses.

A

False. Native and imported horses are equally affected.

46
Q

How is anhidrosis diagnosed?

A

History, PE, and response to intradermal injections of epinephrine at different concentrations.

In normal horses, sweating occurs over the injection sites within minutes at all dilutions.

Anhidrotic horses respond to only the 1:1000 dilution (most concentrated) and then only after 5h or more.

47
Q

What medication effectively treats anhidrosis?

A

Nothing is consistently beneficial.

Can try oral and IV electrolyte supplements, Vit E, iodinated casein, amino acids, or ACTH.
Nothing officially works.

48
Q

What treatment is effective for anhidrosis?

A

Moving animal to cooler climate. Air conditioned, low-humidity stalls. Only exercise when it’s cool.

49
Q

What are some of the fun cowboy names for pastern dermatitis?

A

Grease heel, scratches, cracked heels, mud fever, verrucous pododermatitis, grapes

50
Q

In which breed is pastern dermatitis most commonly diagnosed?

A

Draft horses

51
Q

Describe the general symptomatic care for pastern dermatitis.

A
  1. Get them out of the mud
  2. Minimize contact with potentially irritating chemicals, dusts, plants
  3. Clip and clean
  4. Topicals - daily shampoo or soak. Antimicrobial and/or anti-inflammatory
  5. Systemic antibiotics, steroids or both